Increasing similarities between young adults’ smoking and snus use in Norway: a study of the trends and stages of smoking and snus epidemic from 2010 to 2018

Abstract

Background The prevalence of smoking has been decreasing in Norway for decades. In contrast, the prevalence of snus use has recently increased substantially, especially among females. While there is a clear social gradient in smoking, with a higher smoking prevalence among individuals with low socioeconomic status (SES), a possible social gradient in snus use has been less studied. The aim of the current study was to investigate the trends of smoking and snus use and to examine whether ongoing changes in snus use are similar to prior smoking epidemic development. Methods The study was based on the 2010 (n = 5836), 2014 (n = 13,319) and 2018 (n = 24,515) waves from a nation-wide, cross-sectional, health survey of higher education in Norway (the SHoT study). Variables on smoking, snus use, gender, age and SES were used. Chi-square tests and logistic regression analyses were used to test significance, and Mantel–Haenszel weights were used to test the trends in stratified cross-tabulations. Results Daily smoking decreased from 5.9 to 1.5% between 2010 and 2018, while daily snus use increased from 13.4 to 19.9%. Female snus use almost doubled, from 10.9 to 19.2%. Low SES was associated with both daily smoking and snus use across all three waves. Occasional smoking was also associated with low SES at all waves, but occasional snus use was only associated with low SES in 2010. There were no significant changes over time in either the association between occasional or daily smoking and SES or the association between occasional or daily snus use and SES. Conclusions The overall smoking decrease indicated that the Norwegian smoking epidemic is in its latest stage. Steady male snus use, doubled female snus use and a clear social gradient in snus use all indicate that the snus epidemic in Norway has progressed. If this trend continues, a main implication is that snus prevalence will soon peak, first in males and then in females.

Focus on Self-Presentation on Social Media across Sociodemographic Variables, Lifestyles, and Personalities: A Cross-Sectional Study

“…The associations were estimated separately for each covariate. Gender is likely to be an important confounding variable, as it has been shown to be related to both upward social comparison and self-presentation [ 73 , 74 , 75 ] and to several of the covariates [ 76 , 77 , 78 ]. Therefore, the multinominal logistic regressions were run with and without controlling for gender.…”

Prevalence, duration of exposure and predicting factors for snus use among young Finnish men: a cross-sectional study

“…2 3 As a result, the use of typically conveniently portion-packed Swedish type of moist smokeless tobacco called snus has increased in Europe, particularly in the Nordic countries. [4][5][6][7][8][9] In addition, a similar trend has been observed in the USA during the last decade among younger generations. [10][11][12][13] The marketing of snus is banned in all European Union countries except Sweden.…”

“… 4 However, respondents with an upper secondary education had a significantly lower total exposure time to snus than respondents with a comprehensive education, which is in line with recent studies assessing the association with low socioeconomic status. 8 49 The perception of harmfulness was related to a lower exposure time, confirming health education as an effective tool for preventive interventions. This observation reinforces the common perception that education correlates with health behaviour.…”

Establishing the Association Between Snus Use and Mental Health Problems: A Study of Norwegian College and University Students

“…Compared with the smoking epidemic, the snus epidemic in Norway 49 is in an earlier stage. Furthermore, the snus epidemic seems to develop much more quicker than smoking did, and it also appears to affect a smaller proportion of the Norwegian population as snus prevalence has not reached the same high prevalence as smoking did in the sixties and seventies.…”

“…We believe that the present study supports this implication. Second, it indicates that as the snus epidemic in Norway 49 evolves, the present increased prevalence of mental health problems in snus users will probably increase as female snus users also increases.…”